A 30-year-old man presents with hemoptysis and rapidly progressive glomerulonephritis. Renal biopsy shows linear IgG deposition along the glomerular basement membrane. Lung biopsy in this patient would most likely show:

• A Necrotizing granulomatous inflammation of small vessels with neutrophilic capillaritis
• B Granular IgA deposits in mesangial regions of alveolar capillaries
• C Caseating granulomas with acid-fast bacilli
• D Pulmonary hemorrhage with linear IgG deposition along alveolar basement membranes ✓

Explanation

Goodpasture syndrome is caused by antibodies against the noncollagenous domain of the alpha-3 chain of type IV collagen, producing linear IgG staining on both glomerular and alveolar basement membranes with pulmonary hemorrhage and crescentic glomerulonephritis. Necrotizing granulomatous vasculitis with c-ANCA positivity defines granulomatosis with polyangiitis, the main mimic, and caseating granulomas indicate tuberculosis.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.